Middle Range Theories

How long does chronic sorrow last?

- As long as the desparity of the loss remains, can be forever

How is chronic sorrow clearly different from prevalent, traditional time-bound models of grief and clearly different from pathological depression?

- Considered a normal response - Normal for this sorrow to continue as long as the loss remains, which can be forever

Why are Middle Range theories attractive to nurse researchers?

- Easier to understand - More applicable

Who is Friedrich Nietzsche?

- Existentialism

What are some interventions that are congruent with comfort theory?

- Guided imagery - Progressive muscular relaxation - Meditation - Music or art therapies - Massage - Therapeutic touch

Events antecedent to chronic sorrow?

- Involvement in a circumscribed or single loss event - Recognized negative disparity between the past and the present - The occurrence of events that bring the negative disparity into focus

Why is it important to understand and be sensitive to the mechanisms of trigger events?

- The context of nursing work may become a trigger event for you, your patients, or your patients' families.

What is the theory of comfort?

- The declining significance of comfort for patients - 3 forms in each of the 4 contexts - nursing research provides the public and the decision-makers rationale why nurses and other health care providers should focus on patient comfort beyond altruistic reasons - provision of comfort requires knowledge and skills, and individualized attention

What is mastery of stress?

- The product of the reactions, the anguish, the suffering, the stress, the coping and the efforts to overcome

What is not mastery of stress?

- absence of anguish, suffering, and stress - no reactions to stress - coping with stressful events with ease - coping in any form - efforts to deal with the situation

A concept analysis?

- critical and essential step in theory development - means to trace the origins and evolution of a word in an extensive literature search of usage of the word in nursing, medicine, theology, ergonomics, psychology, and psychiatry - compare current use to obsolete

What are professional interventions for chronic sorrow?

- helpful to ask what helps. helps patients and families realize that they are coping - if nothing helps, suggest some of the coping strategies - must be based on the conceptualization of chronic sorrow as normal rather than pathological

What is the theory of chronic sorrow?

- helping nurses work with and understand the responses of patients and families who have experienced a significant loss - includes a concept analysis (analysis for the concept of chronic sorrow as documented in the literature by multiple disciplines) & 10 qualitative studies designed to explore/investigate the experiences of ppl who experience chronic sorrow - a normal response, universally experienced by those who suffer a significant loss - continues as long as the disparity created by the loss remains

What is the theory of mastery of stress?

- how individuals master difficulties and bad circumstances - goal of this: those who have suffered can emerge healthier and possibly stronger

What are some of the items explored on the comfort questionnaire?

- i don't want to exercise - my body is relaxed right now - i am inspired to do my best

Middle range theory?

- less abstract than grand nursing theories - concerned with specific phenomena found in nursing practice - useful to nurse researchers who want to test interventions, develop practice guidelines, and improve specific conditions for patients, fams, and nurses. - easier to understand & more applicable

What are some coping strategies for chronic sorrow?

- maintaining involvement in personal activities and interests - seeking info - concentrating on positive aspects of life - talking with a trusted professional - having a good cry

Grand theory?

- provide a framework to organize nursing knowledge as a whole - allow us to differentiate the discipline of nursing from traditional approaches to diagnosis and treatment of illness as practiced by physicians ex: parse's, orem's, roy's, watson's - not very good for directing, explaining, and predicting nursing in particular situations - not easily verified experimentally - often difficult to understand

Why do researchers perform concept analyses?

- to become as familiar as possible with a concept - look at obsolete and current meanings to gain understanding

How do contemporary definitions of comfort differ from historical definitions of comfort?

Historical: to strengthen, encouragement, support, refreshing or invigorating influence Current: more pharmaceuticals, absence of extreme measures at the end of life